Fungal acne is not exactly what it seems -which is to say that it is not actually acne!
Unlike acne vulgaris, which is an inflammatory condition triggered by Cutibacterium acnes bacteria, ‘fungal acne’ is caused by lipophilic strains of Malassezia yeast -a fungus. The condition is more accurately termed Malassezia (Pityrosporum) Folliculitis. It appears in patches of small papular, pustular, itchy & irritated red bumps which are very uniform in presentation.
If ‘fungal acne’ is not actually acne, what is it? Malassezia (Pityrosporum) Folliculitis is a fungal infection of the pilo-sebaceous unit (hair follicle). It is caused by lipophilic overgrowth of Malassezia yeast strains, often in response to occlusion of the hair follicle or disturbance of the skin's flora.
Malassezia yeast is a normal component of the skin's flora, however in Malassezia (Pityrosporum) Folliculitis it over proliferates by feeding off sebum, which it uses as a source of nutritional energy.
Malassezia (Pityrosporum) Folliculitis is sometimes mistaken for acne vulgaris, however unlike acne vulgaris it is often very itchy, and is not accompanied by comedones. If misdiagnosed and treated as acne vulgaris, Malassezia (Pityrosporum) Folliculitis can persist for years. In cases of Malassezia (Pityrosporum) Folliculitis, the yeast strains are found to be mainly concentrated in the opening of the sebaceous gland.
The condition is more often observed in areas of the body with high sebum output, in cases of hyperhidrosis and in humid climates. Predisposing factors include topical or oral antibiotic use, particularly tetracyclines, oral corticosteroid use, and immunosuppression.
Topical treatments such as selenium sulphide shampoo, econazole solution or topical ketoconazole can be used to resolve the condition, however oral antifungal medications are typically more efficient at treating this condition. Unfortunately, recurrence is common even after successful treatment. Weekly application of a topical treatment may prevent another occurrence.
If you have you have any skin concerns or queries, come in for a consultation with one of our Dermal Clinicians. They can help tailor the perfect skincare and treatment regime for your skin.